A genetically engineered fibrinolytic agent with equivalent efficacy of fibrinolytic agents in regard to 30-day mortality and reduced propensity for systemic bleeding and simple bolus administration.

it is a modified form of human tissue plasminogen activator.

An original trial of tenecteplase at 0.5 mg per kilogram improved reperfusion in clinical outcomes in eligible patients with acute ischemic stroke compared to alteplase.
It is administered in a five second bolus.
It is recommended prior to endovascular thrombectomy.
Its use achieves substantial reperfusion prior to endovascular thrombectomy in 19% of patients with ischemic occlusive strokes.

Tenecteplase is a tissue plasminogen activator that is more fibrin specific and more resistant to plasminogen activator inhibitor and has a longer plasma half live than alteplase so that it can be given as a single intravenous bolus.

Tenecteplase therapy initiated 4.5 to 24 hours after stroke onset in patients with occlusion of the middle cerebral artery or internal carotid artery, most of whom had undergone endovascular thrombectomy, did not result in better clinical outcomes than those with placebo (TIMELESS investigators).

In a  among Chinese patients with ischemic stroke due to large vessel occlusion treatment with tenecteplase administered 4 1/2 to 24 hours after stroke and it resulted in less disability and similar survival compared with treatment, and the incident of symptomatic cranial hemorrhage appeared higher (Aiong Y).

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